| NPI | 1154799724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DE 01-0001493) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 01621) |
| Enumeration Date | 2015-09-12 |
| Last Update Date | 2015-09-12 |