| NPI | 1104247667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 112236) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PR 2056) |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2017-02-21 |