| NPI | 1205300019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 029507-01) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2019-01-15 |
| Last Update Date | 2020-02-21 |