NPI | 1821421306 |
---|---|
Former Name | SARA NICOLE PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 13013) |
Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: FL SI 2251) |
235Z00000X Speech-Language Pathologist, (Licence: FL SZ 6377) | |
Enumeration Date | 2013-08-19 |
Last Update Date | 2014-06-16 |