| NPI | 1104065317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 355) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 7426) |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2015-01-23 |