| NPI | 1366813198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL012584) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008046) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2019-03-19 |