NPI | 1255600391 |
---|---|
Former Name | CRYSTAL ROBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0002552) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 7381) |
Enumeration Date | 2011-12-19 |
Last Update Date | 2024-01-04 |