| NPI | 1356613657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 029275-01) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 306900) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2019-11-01 |