| NPI | 1295345130 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: PA SL015963)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: OR 16823)  | 
| Enumeration Date | 2020-08-05 | 
| Last Update Date | 2022-01-13 |