NPI | 1205129947 |
---|---|
Former Name | JEAN MARY JOHN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS006054) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 07747) |
Enumeration Date | 2011-05-26 |
Last Update Date | 2015-08-07 |