| 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 |