| NPI | 1255601100 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 455661) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00684800) | 
| Enumeration Date | 2012-01-10 | 
| Last Update Date | 2014-06-17 |