NPI | 1679129589 |
---|---|
Former Name | KIMBERLY DAWN OSTERGAARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0004668) |
Enumeration Date | 2019-08-15 |
Last Update Date | 2022-01-13 |