NPI | 1700596509 |
---|---|
Former Name | JORDAN SLOAN CRAIGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 9694) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP14104) |
Enumeration Date | 2022-12-02 |
Last Update Date | 2024-11-06 |