NPI | 1942695325 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2017005866) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 76764) |
235Z00000X Speech-Language Pathologist, (Licence: KS 3719) | |
Enumeration Date | 2015-04-01 |
Last Update Date | 2022-06-17 |