| NPI | 1366050023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11561) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist | 
| Enumeration Date | 2020-07-20 | 
| Last Update Date | 2020-07-21 |