NPI | 1649819905 |
---|---|
Former Name | HALEY JO LUTTEKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 719) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: SD 719-SLP) |
Enumeration Date | 2020-01-03 |
Last Update Date | 2024-06-03 |