NPI | 1366672644 |
---|---|
Former Name | JENNIFER D. TUBBS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL009597) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.010299) |
Enumeration Date | 2009-07-21 |
Last Update Date | 2022-07-21 |