NPI | 1851900039 |
---|---|
Former Name | JORDAN ASHLEY WHITLOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 9633) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 111797) |
Enumeration Date | 2020-07-23 |
Last Update Date | 2020-07-23 |