| NPI | 1396396925 |
|---|---|
| Former Name | BRIELLE LAUREN MOON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH COND.20191029-SP) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |