NPI | 1184265969 |
---|---|
Former Name | JESSICA LYNN BARNES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 1015911682) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 4902) |
235Z00000X Speech-Language Pathologist, (Licence: MN 9484) | |
Enumeration Date | 2019-10-03 |
Last Update Date | 2019-10-03 |