| NPI | 1942673124 |
|---|---|
| Former Name | JESSICA BEATTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MS S4382) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AL 3599) |
| Enumeration Date | 2015-11-10 |
| Last Update Date | 2023-06-07 |