NPI | 1609286517 |
---|---|
Former Name | STACIE MERTOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 024630) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-30 |
Last Update Date | 2017-12-18 |