| NPI | 1376675694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP6466) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL007368) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2017-02-08 |