| NPI | 1669461307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: FL SA38) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL SA38) |
| Enumeration Date | 2005-10-16 |
| Last Update Date | 2011-06-21 |