| NPI | 1760858179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101000875) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.11610) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2016-08-19 |