| NPI | 1871140467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 4029) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |