| NPI | 1548579287 |
|---|---|
| Former Name | CRYSTAL I FAUST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP6965) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP6965) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2013-03-26 |