| NPI | 1972040905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 18936) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA17371) |
| Enumeration Date | 2017-01-29 |
| Last Update Date | 2020-05-04 |