| NPI | 1790034791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL 60214299) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OR 13479) |
| Enumeration Date | 2012-09-05 |
| Last Update Date | 2012-09-05 |