| NPI | 1609120641 |
|---|---|
| Former Name | JESSICA LYNN ELLIOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 7619) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL010755) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2023-08-29 |