| NPI | 1750783981 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 110629) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 14044995) | 
| Enumeration Date | 2014-09-18 | 
| Last Update Date | 2014-09-18 |