| NPI | 1124548904 |
|---|---|
| Former Name | KAYLENE MARIE IDSO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: AZ SLPA10567) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2022-07-21 |