| NPI | 1780827006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KY 4104) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP5823) |
| Enumeration Date | 2009-04-16 |
| Last Update Date | 2012-11-20 |