| NPI | 1497052252 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ME SP2151) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 11566) | 
| Enumeration Date | 2011-02-14 | 
| Last Update Date | 2012-07-12 |