NPI | 1952696080 |
---|---|
Former Name | ASHLEY MARIE MCKEEHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 107403) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2010035947) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2014-08-05 |