NPI | 1376657114 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP006932) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA5662) |
Enumeration Date | 2006-08-18 |
Last Update Date | 2014-04-08 |