| NPI | 1366763104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 5955) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NC 8774) |
| Enumeration Date | 2010-06-16 |
| Last Update Date | 2012-08-10 |