NPI | 1609160753 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 6402) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2009038484) |
235Z00000X Speech-Language Pathologist, (Licence: KS 3083) | |
Enumeration Date | 2011-06-07 |
Last Update Date | 2020-12-01 |