NPI | 1932262425 |
---|---|
Former Name | LISA M PARDUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 3446) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005773) |
Enumeration Date | 2006-12-18 |
Last Update Date | 2014-05-14 |