NPI | 1710072970 |
---|---|
Former Name | CAROLYN MARIE REUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202002446) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-0435) |
Enumeration Date | 2006-10-04 |
Last Update Date | 2007-07-09 |