NPI | 1336515485 |
---|---|
Former Name | KELLY NICOLE WHEELER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15823) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ 7191) |
Enumeration Date | 2015-08-12 |
Last Update Date | 2021-08-30 |