NPI | 1508928425 |
---|---|
Former Name | BROOKE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MT 1137) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ME SP2249) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2020-01-13 |