NPI | 1619134293 |
---|---|
Former Name | JESSICA MARIE GEORGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 014972) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 014972-1) |
235Z00000X Speech-Language Pathologist, (Licence: 014972-1) | |
Enumeration Date | 2008-05-21 |
Last Update Date | 2019-04-05 |