| NPI | 1154767556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.012017) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 12130611) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2015-01-30 |