| NPI | 1972604833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WV SLP-0979) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 05102) |
| 235Z00000X Speech-Language Pathologist, (Licence: VA 2202004847) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2021-08-13 |