| NPI | 1740598697 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP13178) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 1271345) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2020-07-16 |