NPI | 1902147424 |
---|---|
Former Name | KEISHA MAGWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 06902) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP006411) |
Enumeration Date | 2013-03-07 |
Last Update Date | 2017-04-14 |