| NPI | 1790175560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 4480) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP008776) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-07-06 |