| 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 |