| NPI | 1912029109 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 106342) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 01459) | 
| Enumeration Date | 2007-04-06 | 
| Last Update Date | 2014-07-29 |