NPI | 1932544491 |
---|---|
Former Name | LESLIE RAE ROERK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.13152) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL012011) |
Enumeration Date | 2013-05-09 |
Last Update Date | 2023-08-16 |