| NPI | 1770265787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 6733-154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 7152000671) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2024-08-29 |