NPI | 1255811980 |
---|---|
Former Name | BETHANY MICHELLE RICHARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP010908) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 114433) |
Enumeration Date | 2018-08-21 |
Last Update Date | 2021-09-30 |