NPI | 1295347094 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SP-2072) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.13049) |
Enumeration Date | 2020-08-21 |
Last Update Date | 2022-02-15 |