| NPI | 1407415078 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 7300) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP010595) | 
| Enumeration Date | 2019-06-07 | 
| Last Update Date | 2020-12-14 |