| NPI | 1134611965 |
|---|---|
| Former Name | TAYLOR NICOLE WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AK 209686) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 235Z00000X Speech-Language Pathologist, (Licence: TX 119191) | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2023-06-20 |