NPI | 1700264876 |
---|---|
Former Name | KAITLIN AMANDA BAARCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.012604) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 24086) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2021-10-01 |