NPI | 1245781863 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60679698) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL010915) |
Enumeration Date | 2016-10-19 |
Last Update Date | 2016-10-19 |