NPI | 1831697465 |
---|---|
Former Name | MEGAN ANN GRISSOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146014880) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NV SP-2076) |
Enumeration Date | 2018-01-29 |
Last Update Date | 2022-11-18 |