| NPI | 1518317221 |
|---|---|
| Former Name | MELISSA COSTELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: IN 22007821A) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: SC 5823) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2022-01-17 |