NPI | 1518421411 |
---|---|
Former Name | JESSICA SALLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH Sp.13243) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH sp-13243) |
Enumeration Date | 2019-01-24 |
Last Update Date | 2021-12-08 |