| NPI | 1205200193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60616830) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00723400) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2021-06-22 |