| NPI | 1972982700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP011764) | 
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NC 11400) | 
| 235Z00000X Speech-Language Pathologist, (Licence: SC 7668) | |
| Enumeration Date | 2015-05-26 | 
| Last Update Date | 2025-08-28 |