| NPI | 1760544183 |
|---|---|
| Other Name | STACIA SYDELLE IVENER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: AZ TSLP5241) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2023-03-08 |