| NPI | 1700011715 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: FL 12156718)  | 
| Additional Taxonomies | 222Q00000X Developmental Therapist | 
| Enumeration Date | 2009-05-19 | 
| Last Update Date | 2018-05-30 |