NPI | 1548380918 |
---|---|
Former Name | SERENA M VALDIVIESO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 3582) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA slp006461) |
Enumeration Date | 2007-03-30 |
Last Update Date | 2019-07-15 |