| NPI | 1164609301 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: WV 32)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: WV 59)  | 
| Enumeration Date | 2008-01-30 | 
| Last Update Date | 2013-03-31 |