NPI | 1508172644 |
---|---|
Former Name | KATHLEEN MARIE TUCEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2011018380) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2010028871) |
Enumeration Date | 2010-08-26 |
Last Update Date | 2012-09-28 |