| NPI | 1609156629 |
|---|---|
| Former Name | CAROLYN ANNE BAZAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 013497-being reactiv) |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2018-08-13 |