NPI | 1164707543 |
---|---|
Former Name | JENNIFER BADE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 707-SLP) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 3618) |
Enumeration Date | 2011-10-17 |
Last Update Date | 2023-10-26 |