| 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 |