| NPI | 1164987954 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 031000) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, | 
| Enumeration Date | 2019-02-05 | 
| Last Update Date | 2024-12-16 |