| NPI | 1548651672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 00255) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 9031) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |