| NPI | 1770198434 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 284679) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND.20201467) |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2023-05-22 |