NPI | 1457684276 |
---|---|
Former Name | SHELLY M BENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202009088) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 06103) |
Enumeration Date | 2009-09-11 |
Last Update Date | 2019-05-10 |