| NPI | 1619356375 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 3819) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NE 1761) | 
| Enumeration Date | 2015-05-27 | 
| Last Update Date | 2022-09-07 |