| NPI | 1144626367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP010613) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PR 0003012) |
| Enumeration Date | 2014-11-16 |
| Last Update Date | 2020-06-21 |