| NPI | 1164683033 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 9027) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005520) | 
| Enumeration Date | 2008-06-23 | 
| Last Update Date | 2014-10-07 |