NPI | 1215335575 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP008561) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0001943) |
Enumeration Date | 2014-12-18 |
Last Update Date | 2014-12-18 |