| NPI | 1861662801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 2818) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 15582) | 
| Enumeration Date | 2008-03-05 | 
| Last Update Date | 2018-10-17 |