NPI | 1669705273 |
---|---|
Former Name | TESSA DAWN SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 0002890) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2008032038) |
235Z00000X Speech-Language Pathologist, (Licence: KS 2490) | |
Enumeration Date | 2009-09-14 |
Last Update Date | 2019-04-20 |