| NPI | 1316405129 |
|---|---|
| Former Name | RAECHAL LYNN MACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 030181) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2022-11-02 |