NPI | 1104477223 |
---|---|
Former Name | REBECCA LYNN MOSLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 111664) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA 1168852) |
235Z00000X Speech-Language Pathologist, (Licence: MO 2020023156) | |
Enumeration Date | 2019-09-20 |
Last Update Date | 2020-08-12 |