NPI | 1215960208 |
---|---|
Former Name | KELLY J MONTACUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 3968) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 114176) |
Enumeration Date | 2006-07-10 |
Last Update Date | 2007-07-08 |