| NPI | 1962096537 |
|---|---|
| Former Name | JODY LEE HEETLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NE 2631) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 099499) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2023-11-15 |