| NPI | 1790056349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 107419) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: 12127176) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2022-09-26 |