| NPI | 1700461449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 71091006397) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 71091006397) |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2021-03-15 |