| NPI | 1164977930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 794-154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OR 15458) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2016-08-22 |