NPI | 1720646714 |
---|---|
Former Name | ELIZABETH DIVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.13487) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH sp-13487) |
Enumeration Date | 2019-06-04 |
Last Update Date | 2022-01-20 |