| NPI | 1619421757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP10157) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 112023) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |