| NPI | 1578882064 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 11966) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 12776) | 
| 235Z00000X Speech-Language Pathologist, (Licence: AL 3094) | |
| Enumeration Date | 2010-05-23 | 
| Last Update Date | 2013-08-08 |