| NPI | 1205292943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1717) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 5692) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2019-10-24 |