| NPI | 1619226008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 5101) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA slp007444) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-08-31 |