| NPI | 1457847857 | 
|---|---|
| Former Name | REBECCA MARIE BOURQUE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: LA 8312)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: TX 114646)  | 
| Enumeration Date | 2018-07-09 | 
| Last Update Date | 2022-04-25 |