| NPI | 1104042340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 5339) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 24833) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-06-13 |