NPI | 1366005365 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA17890) |
Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
Enumeration Date | 2019-04-16 |
Last Update Date | 2023-11-01 |