| NPI | 1639550288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1710) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV P/SLP0628) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2020-08-25 |