| NPI | 1922762608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 222Q00000X Developmental Therapist (Licence: FL SL4979) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist Speech-Language Assistant (Licence: FL SL4979) |
| Enumeration Date | 2021-10-28 |
| Last Update Date | 2021-10-28 |