| NPI | 1104145937 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP6243) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 1394) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2011-02-01 |