| NPI | 1730578147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101005707) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 4066-154) |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2018-03-17 |