| NPI | 1174216766 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: LA 8708)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: LA 14360672)  | 
| Enumeration Date | 2023-05-30 | 
| Last Update Date | 2023-05-30 |