NPI | 1306098660 |
---|---|
Former Name | BROOKE ELIZABETH CARROLL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146-008493) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 8885) |
Enumeration Date | 2008-10-17 |
Last Update Date | 2012-07-09 |