NPI | 1952965410 |
---|---|
Former Name | SARAH BETH DERIEMACKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN 6415) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2019-04-30 |
Last Update Date | 2020-08-12 |