NPI | 1912689316 |
---|---|
Former Name | STEPHANIE RENE CHUSTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 121279) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: LA 8653) |
Enumeration Date | 2023-08-04 |
Last Update Date | 2025-03-31 |