NPI | 1508049891 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP1422) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: UT 354438-4102) |
Enumeration Date | 2007-12-10 |
Last Update Date | 2007-12-10 |