NPI | 1710463864 |
---|---|
Former Name | LENA GRACE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 05947) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.014931) |
Enumeration Date | 2018-07-12 |
Last Update Date | 2024-08-27 |