| NPI | 1124560933 |
|---|---|
| Former Name | NICOLE CELESTE REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: OK 5495) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: TN 6075) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2021-08-05 |