| NPI | 1124508395 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP11395) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP11395) | 
| Enumeration Date | 2018-08-17 | 
| Last Update Date | 2022-04-29 |