| NPI | 1396968293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP5502) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 100705) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-08-22 |