| NPI | 1679072706 |
|---|---|
| Former Name | JOLYN KISIDAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 13583) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL013265) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2023-06-29 |