NPI | 1790091114 |
---|---|
Former Name | JESSICA N GILHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: MO 2011020650) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: MO 2010027724) |
Enumeration Date | 2010-08-23 |
Last Update Date | 2012-09-07 |