| NPI | 1780067462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 9519) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CT 005005) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |