| NPI | 1275821621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11919) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL01020) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2019-12-12 |