NPI | 1669739900 |
---|---|
Former Name | AMANDA MARIE SALLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11900) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP009604) |
235Z00000X Speech-Language Pathologist, (Licence: FL SZ5421) | |
Enumeration Date | 2012-04-11 |
Last Update Date | 2022-07-21 |