| NPI | 1114368909 |
|---|---|
| Former Name | NICOLE DUPONT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP11196) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH 2014002) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2018-02-28 |