NPI | 1205230463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA17692) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 104829) |
235Z00000X Speech-Language Pathologist, (Licence: PA SL013837) | |
Enumeration Date | 2014-10-17 |
Last Update Date | 2021-08-03 |