| NPI | 1528071461 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007795) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OK 3104) | 
| Enumeration Date | 2006-08-14 | 
| Last Update Date | 2012-04-24 |