NPI | 1225376650 |
---|---|
Former Name | MACY SCHULTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 757-slp) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 002301) |
Enumeration Date | 2013-01-18 |
Last Update Date | 2022-08-17 |