| NPI | 1902954167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA PCET001860) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT004842) |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2013-01-03 |