NPI | 1104286913 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1711) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2016-03-07 |
Last Update Date | 2024-12-09 |