| NPI | 1760786438 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 18311) | 
| Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 14579) | 
| Enumeration Date | 2011-01-10 | 
| Last Update Date | 2024-09-05 |