| NPI | 1194377721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: SD 970) |
| Enumeration Date | 2019-07-13 |
| Last Update Date | 2022-06-29 |