| 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 |