NPI | 1306006648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA7118) |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
Enumeration Date | 2008-06-10 |
Last Update Date | 2011-01-26 |