NPI | 1437794559 |
---|---|
Former Name | MICHELLE THERESA BRUNNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.012593) |
Enumeration Date | 2019-11-13 |
Last Update Date | 2024-11-11 |