| NPI | 1700017159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 9973) | 
| Additional Taxonomies | 222Q00000X Developmental Therapist (Licence: FL SA 9973) | 
| Enumeration Date | 2009-08-03 | 
| Last Update Date | 2016-03-15 |