| NPI | 1275419442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 123456) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 38159) |
| Enumeration Date | 2025-08-13 |
| Last Update Date | 2025-08-13 |