NPI | 1376628669 |
---|---|
Former Name | SARA M AVERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 8655) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 04549) |
Enumeration Date | 2006-10-26 |
Last Update Date | 2011-01-18 |