NPI | 1417411661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL011856) |
Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech (Licence: PA SL011856) |
Enumeration Date | 2019-01-22 |
Last Update Date | 2023-03-12 |