| NPI | 1396547048 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA10418) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL SA10418) | 
| 252Y00000X Early Intervention Provider Agency (Licence: FL SA10418) | |
| 261Q00000X Clinic/Center (Licence: FL SA10418) | |
| Enumeration Date | 2025-03-25 | 
| Last Update Date | 2025-05-08 |