| NPI | 1780918953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP7505) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 15247) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2012-07-12 |