| NPI | 1922695899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local (Licence: ME SP3894) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2020-12-28 |
| Last Update Date | 2024-06-14 |