| NPI | 1609157726 |
|---|---|
| Former Name | JESSICA ROSE NYBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 21348) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 106080) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2025-08-25 |