NPI | 1407956337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-0383) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP4787) |
Enumeration Date | 2006-09-22 |
Last Update Date | 2007-07-08 |