| NPI | 1619588696 |
|---|---|
| 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 | 2021-05-07 |