| NPI | 1265885628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 031002) |
| Additional Taxonomies | 251C00000X |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2021-09-16 |