NPI | 1689284069 |
---|---|
Former Name | KRISTEN ALEXA SKONBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202009628) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: LA 7936) |
Enumeration Date | 2020-07-31 |
Last Update Date | 2024-05-24 |