NPI | 1922386168 |
---|---|
Former Name | BREANNA MARIE SUTHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NH 1364) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 77930) |
Enumeration Date | 2011-07-21 |
Last Update Date | 2022-05-11 |