| NPI | 1881197838 |
|---|---|
| Former Name | JOHNA SERENITY VANDYKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2015033632) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00934200) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |