NPI | 1801295142 |
---|---|
Former Name | KAYLI ELIZABETH SELF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: TX 113814) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: GA PCET002088) |
Enumeration Date | 2014-08-21 |
Last Update Date | 2022-08-31 |