NPI | 1760747190 |
---|---|
Former Name | WHITNEY JEAN BRANNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11660) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AR P8512) |
Enumeration Date | 2012-07-11 |
Last Update Date | 2012-07-11 |