NPI | 1104291590 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 114557) |
Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: PR 1563) |
235Z00000X Speech-Language Pathologist, (Licence: PR 4024) | |
Enumeration Date | 2015-12-10 |
Last Update Date | 2021-09-01 |