| NPI | 1700575487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OK 6155) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2024-06-09 |