| NPI | 1861874042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 745698) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 745698) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |