| NPI | 1609274802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 584) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2007006503) |
| Enumeration Date | 2014-12-21 |
| Last Update Date | 2014-12-21 |