| NPI | 1568597458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 10403) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL008123) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2021-01-19 |