NPI | 1285349035 |
---|---|
Former Name | ELLORA GALLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL016822) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.15052) |
Enumeration Date | 2023-01-17 |
Last Update Date | 2023-01-17 |