NPI | 1689416604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202011443) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101008733) |
Enumeration Date | 2024-06-10 |
Last Update Date | 2024-06-19 |