NPI | 1972742096 |
---|---|
Former Name | LISA RENEE BUTCHER-PETERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MN 8427) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WI 3167-154) |
Enumeration Date | 2009-02-12 |
Last Update Date | 2022-01-07 |