NPI | 1114174158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2005019641) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 2724) |
235Z00000X Speech-Language Pathologist, (Licence: 12076255) | |
Enumeration Date | 2008-08-21 |
Last Update Date | 2008-08-21 |