| NPI | 1225485717 |
|---|---|
| Former Name | KENZIE REBECCA SOUTHARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 026661-1) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2025-05-01 |