| NPI | 1265868004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 13128) |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: FL SA 13128) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2016-03-11 |