| NPI | 1407124308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 14320) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 8432) |
| Enumeration Date | 2011-12-06 |
| Last Update Date | 2011-12-06 |