NPI | 1962968750 |
---|---|
Former Name | LACI DEARDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 151648) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO 12123658) |
Enumeration Date | 2019-02-16 |
Last Update Date | 2020-01-02 |