| NPI | 1417371055 |
|---|---|
| Former Name | LINNAYA MANGRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: MI 7101005566) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2019-09-16 |