| NPI | 1740633684 |
|---|---|
| Former Name | LAURA WELLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 28844) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 9710) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2019-07-11 |