| NPI | 1508140401 |
|---|---|
| Former Name | HEATHER KETCHUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AL 3454) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA PCET001675) |
| 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007875) | |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2013-06-04 |