| NPI | 1508099623 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: SC 4402)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: GA SLP007491)  | 
| Enumeration Date | 2009-08-25 | 
| Last Update Date | 2011-07-08 |