| NPI | 1700480621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 78368) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL015513) |
| Enumeration Date | 2020-11-23 |
| Last Update Date | 2022-08-15 |