NPI | 1730318189 |
---|---|
Former Name | NICHOLE MARIE BOECKMANN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 025348) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.010878) |
Enumeration Date | 2009-07-07 |
Last Update Date | 2017-02-15 |