| NPI | 1417397654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP8362) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: UT 558101) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2014-06-06 |