NPI | 1184363368 |
---|---|
Former Name | MICKAYLA M WENZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 30001584) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IN 22008049A) |
Enumeration Date | 2022-06-03 |
Last Update Date | 2024-05-08 |