| NPI | 1376104711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 010531) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL 17194) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2019-06-26 |