| NPI | 1881229821 |
|---|---|
| Former Name | NICOLE YVETTE EBALO ROSALES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NV SP-2502) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 21121) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2020-03-10 |