| NPI | 1720318223 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA8811) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP18008) | 
| Enumeration Date | 2010-01-05 | 
| Last Update Date | 2010-01-05 |