| NPI | 1184831976 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 107709) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: TN 1506) |
| 231H00000X Audiologist (Licence: TX 80482) | |
| 235Z00000X Speech-Language Pathologist, (Licence: TN TN1807) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2019-09-16 |