| NPI | 1770832602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL 00004702) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OR 12956) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |