NPI | 1255878682 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP009191) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 113232) |
Enumeration Date | 2017-01-24 |
Last Update Date | 2019-09-04 |