| NPI | 1720124514 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: FL OT3260)  | 
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: FL OT3260)  | 
| Enumeration Date | 2007-01-29 | 
| Last Update Date | 2011-03-03 |