| NPI | 1639505993 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ND 1234) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 111513) | 
| Enumeration Date | 2013-09-18 | 
| Last Update Date | 2022-07-21 |