NPI | 1609121946 |
---|---|
Former Name | STEFANIE LEAFBLAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: LA 6769) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: TX 107673) |
Enumeration Date | 2012-07-23 |
Last Update Date | 2018-03-17 |