NPI | 1740361450 |
---|---|
Former Name | SUSAN MARIE FEDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 5815) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 770154) |
235Z00000X Speech-Language Pathologist, (Licence: ND 1333) | |
Enumeration Date | 2006-10-18 |
Last Update Date | 2014-10-01 |