| NPI | 1396831103 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 18171) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA249) | 
| Enumeration Date | 2006-10-05 | 
| Last Update Date | 2011-02-02 |