NPI | 1811217508 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 10710) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL003512L) |
Enumeration Date | 2010-06-04 |
Last Update Date | 2011-01-10 |