NPI | 1891976163 |
---|---|
Former Name | CARRIE ELIZABETH LOPEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008058) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-1660) |
Enumeration Date | 2007-11-15 |
Last Update Date | 2019-09-10 |