NPI | 1174890719 |
---|---|
Former Name | CRYSTAL MICHELLE DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 11-083) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2011-11-28 |
Last Update Date | 2024-03-20 |