NPI | 1912320193 |
---|---|
Former Name | MELISSA ANNE GILLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.11337) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND. 2013205) |
Enumeration Date | 2014-01-24 |
Last Update Date | 2016-08-24 |