| NPI | 1497291918 |
|---|---|
| Former Name | KATIE JOHNSON BROYLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 6179) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202007043) |
| Enumeration Date | 2017-01-08 |
| Last Update Date | 2024-05-15 |