NPI | 1447450911 |
---|---|
Former Name | KRISTIN FERGUSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202005247) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 06913) |
Enumeration Date | 2007-07-23 |
Last Update Date | 2019-07-11 |