| NPI | 1558707034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 4268) |
| Additional Taxonomies | 174400000X Specialist (Licence: KY 4268) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2020-10-13 |