NPI | 1518267046 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006702) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 019755) |
Enumeration Date | 2010-11-01 |
Last Update Date | 2012-07-23 |