NPI | 1578041794 |
---|---|
Former Name | JORDAN BAKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.13528) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND.2018728-SP) |
Enumeration Date | 2018-07-31 |
Last Update Date | 2024-07-30 |