| NPI | 1790164283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 4117-154) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 9463) |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2017-01-23 |