NPI | 1679616494 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1479) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL008583) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2014-07-09 |