| NPI | 1770175051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 9632) |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech (Licence: MA 9632) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-11-05 |