NPI | 1265823009 |
---|---|
Former Name | JESSICA MAE WOLFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 13270) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA13296) |
Enumeration Date | 2015-02-16 |
Last Update Date | 2018-11-09 |