| NPI | 1528396744 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: SC 2634)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: GA SLP004216)  | 
| Enumeration Date | 2009-11-29 | 
| Last Update Date | 2009-11-29 |