| NPI | 1528292463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP4790) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OK 2010) |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-06 |