| NPI | 1386124477 |
|---|---|
| Former Name | MADISON ALICE ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: TN 8380) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2023-09-12 |