| NPI | 1396357539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 77564) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 113364) | 
| 235Z00000X Speech-Language Pathologist, (Licence: RI SP01562) | |
| Enumeration Date | 2020-08-19 | 
| Last Update Date | 2020-08-19 |