NPI | 1679850275 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP003707) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA10705) |
Enumeration Date | 2011-11-09 |
Last Update Date | 2022-07-06 |