| NPI | 1114193059 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN SP 0000002282) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP004693) | 
| Enumeration Date | 2008-04-30 | 
| Last Update Date | 2008-10-23 |