| NPI | 1205109493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN SP0000000647) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MS S3632) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2012-02-17 |