| NPI | 1194733295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006220) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CT 4040) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2011-02-25 |