NPI | 1972884567 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007787) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 11122) |
Enumeration Date | 2011-09-08 |
Last Update Date | 2022-03-20 |