| NPI | 1366519316 |
|---|---|
| Former Name | SHANNON PEEKSTOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: FL SA 9236) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: FL SZ 4037) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2010-06-09 |