NPI | 1972896348 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 14128) |
Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: FL SA14128) |
Enumeration Date | 2011-05-18 |
Last Update Date | 2023-10-21 |