| NPI | 1700256872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2020016725) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NE 2013011273) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2020-08-18 |