| NPI | 1184970154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 77238-SP-SL) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2019-06-30 |