| NPI | 1194972661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007253) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005457) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2016-01-07 |