NPI | 1962721522 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60193944) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP006574) |
Enumeration Date | 2010-05-21 |
Last Update Date | 2021-10-05 |