| NPI | 1902256340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: IL 140.015032) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2020-06-29 |