| NPI | 1740957810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 032063) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2024-08-02 |