NPI | 1578041554 |
---|---|
Former Name | TIFFANY STEVENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL61321905) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP28481) |
Enumeration Date | 2018-08-01 |
Last Update Date | 2023-02-20 |