| NPI | 1295955961 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 142549) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KY 3011) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2018-05-16 |