| NPI | 1790057248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL001009L) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ slp5388) |
| Enumeration Date | 2012-01-30 |
| Last Update Date | 2012-01-30 |