| NPI | 1629510938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3739) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KY 169080) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2025-12-19 |