NPI | 1962845701 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP9886) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH 12142494) |
Enumeration Date | 2013-04-11 |
Last Update Date | 2020-05-11 |