| NPI | 1912113648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP1097) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ID ASHA10005310) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-06-10 |