NPI | 1396263596 |
---|---|
Former Name | JESSICA BEITZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: LA 7525) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
Enumeration Date | 2017-09-07 |
Last Update Date | 2024-04-13 |