| NPI | 1164736484 |
|---|---|
| Former Name | JENICA ANN LEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 19201) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 242.001620) |
| Enumeration Date | 2010-07-28 |
| Last Update Date | 2013-05-07 |