| NPI | 1104330158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0003190) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2021015005) |
| 235Z00000X Speech-Language Pathologist, (Licence: NM 6372) | |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2021-07-12 |