NPI | 1811276785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007036) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00195300) |
Enumeration Date | 2011-08-10 |
Last Update Date | 2011-08-10 |