| NPI | 1639782337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 5307) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: MA 18) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-08-24 |