NPI | 1972884864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MT SLP-SP-LIC-4900) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 020233-1) |
Enumeration Date | 2011-09-06 |
Last Update Date | 2016-08-27 |