NPI | 1245595107 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA Sp4303) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CA 1-09-6392) |
Enumeration Date | 2012-07-06 |
Last Update Date | 2012-07-06 |