NPI | 1518419209 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005545) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ME SP2612) |
Enumeration Date | 2016-10-27 |
Last Update Date | 2016-10-27 |