| NPI | 1629717095 |
|---|---|
| Former Name | JESSICA PAIGE SPAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202011767) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 114689) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2025-02-04 |