| NPI | 1639299811 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: LA 4785)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: TX 103013)  | 
| 235Z00000X Speech-Language Pathologist,   (Licence: CA SP 15711)  | |
| Enumeration Date | 2007-03-30 | 
| Last Update Date | 2013-06-13 |