NPI | 1700105632 |
---|---|
Former Name | JAMIE BOSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL010334) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2010-05-17 |
Last Update Date | 2018-03-17 |