| NPI | 1962899625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 11962) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 07770) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2016-10-11 |