NPI | 1477107795 |
---|---|
Former Name | ELIZA JEAN NEWCOMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DE O1-0001675) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL007689) |
Enumeration Date | 2019-07-25 |
Last Update Date | 2022-01-03 |