| NPI | 1417363367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP 9103) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 101026) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2014-11-18 |