| NPI | 1962078030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP011990) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA PCET003309) |
| Enumeration Date | 2021-05-31 |
| Last Update Date | 2022-04-01 |