NPI | 1376970749 |
---|---|
Former Name | WENDY PORTILLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DC SLP000786) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: DC OSSE license) |
Enumeration Date | 2013-10-01 |
Last Update Date | 2024-08-27 |