NPI | 1821240078 |
---|---|
Former Name | MARY E POTTORF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist |
Additional Taxonomies | 231H00000X Audiologist (Licence: KS 801) |
235Z00000X Speech-Language Pathologist, (Licence: KS 3043) | |
Enumeration Date | 2008-10-21 |
Last Update Date | 2013-05-02 |