| NPI | 1851674519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60244300) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA MA60330991) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2015-10-28 |