| NPI | 1225614704 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: UT 12113552-4102) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 23254) | 
| 261QH0700X Clinic/Center, Hearing and Speech (Licence: UT 12113552-4102) | |
| 261QH0700X Clinic/Center, Hearing and Speech (Licence: CA 23254) | |
| Enumeration Date | 2021-03-23 | 
| Last Update Date | 2021-03-23 |