NPI | 1346535671 |
---|---|
Former Name | KRISTEN ELYCE BURKHART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 17880) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 12374) |
Enumeration Date | 2011-06-15 |
Last Update Date | 2014-03-17 |