NPI | 1326285164 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007290) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 018721-1) |
Enumeration Date | 2009-01-15 |
Last Update Date | 2016-11-28 |