NPI | 1306191713 |
---|---|
Former Name | AMY OLDHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MT 3099) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 014688-1) |
Enumeration Date | 2012-07-23 |
Last Update Date | 2013-08-01 |