| NPI | 1538721634 |
|---|---|
| Former Name | ALEXANDRA JEFFERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CT 006969) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 77000) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2022-12-11 |