| NPI | 1821374919 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NE 889) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 001828) | 
| Enumeration Date | 2011-11-02 | 
| Last Update Date | 2011-11-02 |