| NPI | 1114491339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2015015061) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 3333) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-22 |