| NPI | 1770806242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 7809) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NH 1267) | 
| Enumeration Date | 2010-03-11 | 
| Last Update Date | 2010-03-11 |