| NPI | 1750873147 |
|---|---|
| Former Name | ALICIA CARLSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-5800) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ID TSLP-5326) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2023-06-08 |