NPI | 1619606407 |
---|---|
Former Name | KAYLA MARIE MCKIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0004691) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: 14315348) |
Enumeration Date | 2022-06-07 |
Last Update Date | 2022-11-04 |