NPI | 1770925737 |
---|---|
Former Name | JACQUELYN F BUDZIAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60769017) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.009790) |
Enumeration Date | 2013-07-18 |
Last Update Date | 2018-03-17 |