NPI | 1386202364 |
---|---|
Former Name | ALISON CHRISTINE WILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: 12159401) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0003131) |
Enumeration Date | 2019-06-04 |
Last Update Date | 2019-06-04 |