| NPI | 1164767075 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 100997) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, | 
| Enumeration Date | 2012-12-04 | 
| Last Update Date | 2023-06-13 |