| NPI | 1790262780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WY SP-1058) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ID 1963) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2020-01-26 |