| NPI | 1629661996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA LL61166154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 30116) |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-07-19 |