| NPI | 1609067461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 311-154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 5759) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |