NPI | 1144758657 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NY 030354-01) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00287800) |
235Z00000X Speech-Language Pathologist, (Licence: NY 030354-01) | |
Enumeration Date | 2017-05-28 |
Last Update Date | 2021-03-02 |