| NPI | 1326177569 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL sa9205) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA PCET001100) | 
| Enumeration Date | 2007-03-05 | 
| Last Update Date | 2019-04-25 |