NPI | 1235506783 |
---|---|
Former Name | BAILEY BRANHAM REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 113250) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1588) |
Enumeration Date | 2015-08-31 |
Last Update Date | 2020-09-14 |