| NPI | 1184914434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171W00000X Contractor (Licence: AZ 1145) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP5795) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2011-05-02 |