| NPI | 1316466550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1890) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV 0716) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2018-10-31 |