NPI | 1649679010 |
---|---|
Former Name | SURIYAH LEWIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DC SLP000732) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 07256) |
Enumeration Date | 2014-08-21 |
Last Update Date | 2014-10-27 |