| NPI | 1942518055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007854) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 017745) | 
| Enumeration Date | 2010-09-23 | 
| Last Update Date | 2018-03-17 |