NPI | 1215420765 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: GA SLP009763) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: MD 0577) |
235Z00000X Speech-Language Pathologist (Licence: VA 2202005644) | |
Enumeration Date | 2018-06-10 |
Last Update Date | 2018-06-16 |