| NPI | 1104992304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP006686) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP4078) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-04-24 |