| NPI | 1184923039 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11401) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ5366) | 
| Enumeration Date | 2011-03-17 | 
| Last Update Date | 2021-03-19 |