NPI | 1407532476 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech (Licence: GA SLP012163) |
Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech (Licence: FL 19901) |
235Z00000X Speech-Language Pathologist, (Licence: GA SLP012163) | |
Enumeration Date | 2023-06-26 |
Last Update Date | 2023-12-13 |