| NPI | 1649257122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202004583) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA 05056) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2007-07-08 |