NPI | 1487772687 |
---|---|
Former Name | PAMELA JO EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO ASHA Cert 01091600) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0000893) |
Enumeration Date | 2007-03-26 |
Last Update Date | 2022-08-08 |