NPI | 1770993354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202007284) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV 0594) |
Enumeration Date | 2014-05-05 |
Last Update Date | 2017-07-31 |