| NPI | 1790293629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP0000908) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0000908) |
| Enumeration Date | 2018-01-12 |
| Last Update Date | 2018-01-12 |