| NPI | 1902154214 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: UT 89790984102) | 
| Enumeration Date | 2012-08-16 | 
| Last Update Date | 2024-05-15 |