| NPI | 1104129956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0002189) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA10776) |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2015-10-01 |