NPI | 1649562059 |
---|---|
Former Name | LIANNE FAYE FAKTOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.012253) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 105018) |
Enumeration Date | 2011-05-04 |
Last Update Date | 2014-09-02 |