| NPI | 1629396312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007503) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: SC 4450) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2013-03-25 |