NPI | 1255615084 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60301924) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP7472) |
Enumeration Date | 2011-09-28 |
Last Update Date | 2022-06-21 |