| NPI | 1770690125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: FL 9244800) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA 3709) |
| 235Z00000X Speech-Language Pathologist, (Licence: SC 1119) | |
| 235Z00000X Speech-Language Pathologist, (Licence: FL SA3739) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-12-19 |