| NPI | 1700125333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101006066) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 06194) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2021-10-25 |