| NPI | 1275147134 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.14484) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND.20201524-SP) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2022-08-12 |