NPI | 1730553702 |
---|---|
Former Name | AMBER JILL PRENTICE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 15135) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP009559) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2024-12-05 |