| NPI | 1760811491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 376-SLP) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 8978) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |