| NPI | 1942476627 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: MI 7101003946)  | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist,   (Licence: MA 5762)  | 
| Enumeration Date | 2008-05-02 | 
| Last Update Date | 2015-12-15 |