NPI | 1962963009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2023049812) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: KS 4368) |
Enumeration Date | 2019-03-29 |
Last Update Date | 2025-08-06 |