NPI | 1760955363 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP012171) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 01606L) |
235Z00000X Speech-Language Pathologist, (Licence: MD 09349) | |
Enumeration Date | 2019-01-07 |
Last Update Date | 2022-08-10 |