NPI | 1427217892 |
---|---|
Former Name | MAE ELISABETH CONDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 18330) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005487) |
Enumeration Date | 2008-06-02 |
Last Update Date | 2010-09-02 |