| NPI | 1508748559 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 02362) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NH 3340) |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2025-07-22 |