| NPI | 1770870503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1456) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL009914) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2016-09-21 |