NPI | 1407236243 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA14862) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: 1-24-75490) |
Enumeration Date | 2015-06-07 |
Last Update Date | 2024-10-31 |