NPI | 1366830424 |
---|---|
Former Name | MARY KEEFE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.012531) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2014015181) |
Enumeration Date | 2014-12-24 |
Last Update Date | 2015-09-22 |