NPI | 1265830491 |
---|---|
Former Name | KELLY SUE WATKINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP 8850) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 109515) |
235Z00000X Speech-Language Pathologist, (Licence: FL SA 12803) | |
Enumeration Date | 2014-12-22 |
Last Update Date | 2014-12-22 |