| NPI | 1760096853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101005585) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL 16783) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |