NPI | 1831620855 |
---|---|
Former Name | KACY BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 12381) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP011439) |
235Z00000X Speech-Language Pathologist, (Licence: SC 6006) | |
Enumeration Date | 2017-03-22 |
Last Update Date | 2022-02-07 |