| NPI | 1609242601 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15022) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 027755) | 
| Enumeration Date | 2015-08-13 | 
| Last Update Date | 2020-06-24 |