NPI | 1104063171 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 108739) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CO 1/14/9896) |
Enumeration Date | 2009-01-13 |
Last Update Date | 2015-03-20 |