| NPI | 1770143091 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 8341) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NC 14733) | 
| Enumeration Date | 2019-06-18 | 
| Last Update Date | 2023-06-07 |