| NPI | 1255736625 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: WA LL 60337719)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: OR 15042)  | 
| 235Z00000X Speech-Language Pathologist,   (Licence: IA 002290)  | |
| Enumeration Date | 2014-10-28 | 
| Last Update Date | 2014-10-28 |