| NPI | 1588175483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001014639) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0002992) |
| 235Z00000X Speech-Language Pathologist, (Licence: RI SP01377) | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2024-09-29 |