| NPI | 1790096725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101002090) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 105731) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2014-02-13 |