| NPI | 1295041077 |
|---|---|
| Former Name | AMANDA GRANTHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 8835) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 3394) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2011-11-15 |