| NPI | 1174162028 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MT SLP-SP-LIC-8123) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OR 016332) | 
| 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP12183) | |
| 235Z00000X Speech-Language Pathologist, (Licence: CA SP29672) | |
| Enumeration Date | 2019-12-24 | 
| Last Update Date | 2022-06-01 |