NPI | 1205094794 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 6600) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL004901L) |
Enumeration Date | 2008-05-30 |
Last Update Date | 2008-05-30 |