| NPI | 1790111409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007909) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP10446) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |