| NPI | 1811124696 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 231H00000X Audiologist (Licence: MA 486) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 3388) | 
| Enumeration Date | 2009-06-18 | 
| Last Update Date | 2018-06-23 |