| NPI | 1790181634 |
|---|---|
| Former Name | ALISSA FAY HALTOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 107998) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: TX 107998) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2022-10-04 |