NPI | 1740634583 |
---|---|
Former Name | DIANA GORTYCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 116336) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41ys00817500) |
235Z00000X Speech-Language Pathologist, (Licence: WA 61097597) | |
Enumeration Date | 2016-04-18 |
Last Update Date | 2021-08-17 |