NPI | 1215164207 |
---|---|
Former Name | TRACY ANNE BALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2010007402) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 001872) |
Enumeration Date | 2009-06-17 |
Last Update Date | 2013-12-12 |