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 |