| NPI | 1265905681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP12222) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WY SP-886) |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2023-11-16 |