| NPI | 1306391677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101004776) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 3516) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |