NPI | 1427589605 |
---|---|
Former Name | JESSICA LEA IRWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA13179) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP21996) |
Enumeration Date | 2017-03-21 |
Last Update Date | 2017-03-21 |