NPI | 1568865400 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11202) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006776) |
Enumeration Date | 2014-10-07 |
Last Update Date | 2014-10-07 |