| NPI | 1518376540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2015023525) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2014024671) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2015-12-22 |