NPI | 1679096135 |
---|---|
Former Name | CHELSEA PAYNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP009046) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15105) |
Enumeration Date | 2017-07-17 |
Last Update Date | 2022-03-12 |