| NPI | 1366822108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1549) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KY 3764) |
| Enumeration Date | 2015-06-07 |
| Last Update Date | 2015-06-07 |