| NPI | 1154622868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 4777) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006179) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2015-06-18 |