NPI | 1609243005 |
---|---|
Former Name | STEFANIE MICHELE COTTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP010104) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ6681) |
Enumeration Date | 2015-09-01 |
Last Update Date | 2019-04-09 |