NPI | 1861913014 |
---|---|
Former Name | BAILEE MIKELLE GODDARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: UT 13650656-4101) |
Additional Taxonomies | 231H00000X Audiologist (Licence: TX 80984) |
Enumeration Date | 2017-06-28 |
Last Update Date | 2024-02-16 |