| NPI | 1831733419 |
|---|---|
| Former Name | AMANDA BETH BLOMGREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OK 6199) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OK CF548) |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2024-05-13 |