NPI | 1396210175 |
---|---|
Former Name | STEPHANIE MARY POLIDORI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101002172) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 71010002172) |
Enumeration Date | 2018-10-09 |
Last Update Date | 2021-02-24 |