| NPI | 1619389632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2003029512) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 3192) |
| Enumeration Date | 2014-05-26 |
| Last Update Date | 2014-05-26 |