NPI | 1619588696 |
---|---|
Former Name | TESSA BOYLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ME SP3390) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 605939) |
Enumeration Date | 2020-08-12 |
Last Update Date | 2024-12-16 |