NPI | 1417328154 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60561836) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL011305) |
Enumeration Date | 2015-10-07 |
Last Update Date | 2015-10-07 |