| NPI | 1245649532 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP008913) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA PCET002069) | 
| Enumeration Date | 2014-08-12 | 
| Last Update Date | 2016-09-13 |