NPI | 1285813865 |
---|---|
Former Name | HEIDI J BUSH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL 9959) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 5199) |
252Y00000X Early Intervention Provider Agency | |
Enumeration Date | 2007-10-30 |
Last Update Date | 2018-02-21 |