| NPI | 1104012236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 116389) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 4282) |
| 235Z00000X Speech-Language Pathologist, (Licence: NY 009153) | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2020-01-17 |