| NPI | 1790214104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WY SP-825) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WY SP) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-01-07 |