NPI | 1255613683 |
---|---|
Former Name | MICHELLE ASHLEY BERNAT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11544) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ 5424) |
Enumeration Date | 2011-09-12 |
Last Update Date | 2024-02-05 |