NPI | 1902042914 |
---|---|
Former Name | SHELLEY DEE SECOOLISH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 231H00000X Audiologist (Licence: NJ YA00424) |
Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: NJ MG00855) |
Enumeration Date | 2008-12-22 |
Last Update Date | 2020-03-18 |