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 |