| NPI | 1477996312 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 14050848) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 12101) | 
| Enumeration Date | 2013-04-10 | 
| Last Update Date | 2021-04-12 |