| NPI | 1114289097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 009021) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: GA 000184) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-05-06 |