| NPI | 1356814107 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP15255) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 3369) | 
| Enumeration Date | 2019-01-04 | 
| Last Update Date | 2024-07-29 |