NPI | 1225696099 |
---|---|
Former Name | KIRSTEN EILEEN HOLMBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 14396) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ9044) |
Enumeration Date | 2019-06-05 |
Last Update Date | 2022-07-14 |