| NPI | 1356918510 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: MN 518226)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: WI 5245)  | 
| Enumeration Date | 2021-06-07 | 
| Last Update Date | 2022-06-20 |