| NPI | 1770664815 |
|---|---|
| Former Name | TRACI KRISTINE GAMBLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN 4963) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146008086) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2014-05-12 |