| NPI | 1962054767 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 016543) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, | 
| Enumeration Date | 2019-07-11 | 
| Last Update Date | 2023-08-31 |