NPI | 1447520754 |
---|---|
Former Name | MONETA MARIE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 0000781) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2012-01-03 |
Last Update Date | 2015-11-19 |