NPI | 1194083584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA12763) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 04630) |
Enumeration Date | 2012-04-24 |
Last Update Date | 2014-08-14 |