| NPI | 1881063881 |
|---|---|
| Former Name | KATIE FAGERLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008710) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 025739) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2020-06-23 |