| NPI | 1164809059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2019004999) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 242003422) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2019-10-21 |