NPI | 1144743105 |
---|---|
Former Name | KIMBERLEY BROOMFIELD CARROLL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007226) |
Enumeration Date | 2017-07-21 |
Last Update Date | 2017-07-21 |