NPI | 1306210927 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA PCET002286) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP009620) |
Enumeration Date | 2015-11-19 |
Last Update Date | 2018-12-11 |