NPI | 1295453553 |
---|---|
Former Name | ALEXANDRA GAIL MASHBURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.15484) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND.20222115.SP) |
Enumeration Date | 2022-08-22 |
Last Update Date | 2023-08-17 |