NPI | 1538783337 |
---|---|
Former Name | JORDAN SKYLER TRAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AR 201838) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: LA 8554) |
Enumeration Date | 2020-06-08 |
Last Update Date | 2022-07-05 |