| NPI | 1942650205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP1716) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 02616) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-07-25 |