| NPI | 1144547100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: UT 310511-4102) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1303) | 
| Enumeration Date | 2010-04-29 | 
| Last Update Date | 2018-02-15 |