| NPI | 1578702429 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 7455) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NH 1236) | 
| Enumeration Date | 2009-02-17 | 
| Last Update Date | 2020-10-28 |