NPI | 1639379373 |
---|---|
Former Name | MANDY LEE FIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146008812) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0002544) |
Enumeration Date | 2007-07-20 |
Last Update Date | 2016-11-29 |