| NPI | 1104187731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP006246) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA7778) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |