| NPI | 1790078954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 3472-154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 5580) |
| Enumeration Date | 2011-05-20 |
| Last Update Date | 2011-05-20 |