| NPI | 1790174449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: LA 7050) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 22575) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-19 |