| 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 |