NPI | 1487716171 |
---|---|
Former Name | JENNIFER KAY ERD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA 005636) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL sa11634) |
Enumeration Date | 2006-12-16 |
Last Update Date | 2012-06-19 |