NPI | 1689283608 |
---|---|
Former Name | JAMIE LYNN PAYNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 6340-154) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.014772) |
Enumeration Date | 2020-07-26 |
Last Update Date | 2023-09-10 |