NPI | 1790132173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008044) |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
Enumeration Date | 2016-05-16 |
Last Update Date | 2025-09-16 |