NPI | 1225054521 |
---|---|
Former Name | TAYLOR LEIGH POWANDA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA9071) |
Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL SA9071) |
Enumeration Date | 2006-07-14 |
Last Update Date | 2018-08-31 |