NPI | 1942682919 |
---|---|
Former Name | CRYSTAL JEFFERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AK 124313) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NM SLP6046) |
Enumeration Date | 2015-06-25 |
Last Update Date | 2019-01-07 |