NPI | 1417492364 |
---|---|
Former Name | KATELYN CHRISTINE HAYNES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 112265) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP010445) |
Enumeration Date | 2017-01-02 |
Last Update Date | 2018-12-28 |