NPI | 1184962706 |
---|---|
Former Name | MARISSA BRIANNA COFFERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 9394) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ6115) |
Enumeration Date | 2013-01-17 |
Last Update Date | 2014-11-17 |