| NPI | 1811517246 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 116205) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: LA 8149) | 
| Enumeration Date | 2020-04-27 | 
| Last Update Date | 2020-04-27 |