NPI | 1215163290 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2005023175) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146004725) |
Enumeration Date | 2009-06-04 |
Last Update Date | 2020-04-01 |