| NPI | 1770864977 |
|---|---|
| Former Name | JENNIFER DIANNE WADSWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 104644) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: HI 1162) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2022-10-21 |