| NPI | 1629635842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CT 005652) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 028671-1) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2019-05-22 |