NPI | 1710503586 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP011487) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA PCET003110) |
Enumeration Date | 2020-06-17 |
Last Update Date | 2024-11-14 |