NPI | 1215284617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2018009763) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2010028887) |
Enumeration Date | 2012-08-06 |
Last Update Date | 2018-05-15 |