NPI | 1235544495 |
---|---|
Former Name | SHANLEY TABER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 3790) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 3041) |
Enumeration Date | 2014-06-26 |
Last Update Date | 2021-08-25 |