| NPI | 1902031552 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 05649) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: UT 5117111-4102) | 
| Enumeration Date | 2009-05-27 | 
| Last Update Date | 2009-05-27 |