NPI | 1861939860 |
---|---|
Former Name | LORAINE JUDITH KOZICHOUSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP006679) |
Enumeration Date | 2017-01-27 |
Last Update Date | 2017-01-27 |