| NPI | 1407022049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: ME SP812) |
| Additional Taxonomies | 261QH0700X Clinic/Center Hearing and Speech (Licence: ME SP812) |
| Enumeration Date | 2008-05-04 |
| Last Update Date | 2008-05-04 |