| NPI | 1104172840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP008260) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 022059) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2023-01-30 |