NPI | 1619284007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: UT 5166310-4102) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP2165) |
Enumeration Date | 2010-09-07 |
Last Update Date | 2010-09-07 |