| NPI | 1770767048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP5079) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101007890) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2023-10-10 |