| NPI | 1124565221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 12086) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP12981) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2022-08-11 |