NPI | 1356663934 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP004688) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-09-6613) |
Enumeration Date | 2010-02-23 |
Last Update Date | 2023-10-04 |