NPI | 1780219055 |
---|---|
Former Name | TERRA RAE FIRTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MS S3952) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: 6853) |
Enumeration Date | 2020-03-07 |
Last Update Date | 2022-05-13 |