| NPI | 1174179667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2019031246) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 3521) |
| Enumeration Date | 2019-08-12 |
| Last Update Date | 2019-08-12 |