NPI | 1376159558 |
---|---|
Former Name | COLETTE FORTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MT slp-sp-lic-12202) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NV sp-2868) |
235Z00000X Speech-Language Pathologist, (Licence: NM slp7600) | |
Enumeration Date | 2020-09-22 |
Last Update Date | 2024-05-06 |