NPI | 1134487564 |
---|---|
Other Name | MARCY VANCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 19360) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP6767) |
Enumeration Date | 2012-04-23 |
Last Update Date | 2012-04-23 |