| NPI | 1770044489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP11706) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 23716) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |