NPI | 1518412873 |
---|---|
Former Name | LAURA CHRISTINE HERRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NV SP-965) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP-21595) |
Enumeration Date | 2016-08-16 |
Last Update Date | 2016-08-16 |