NPI | 1982075818 |
---|---|
Former Name | KIMBERLY ANN GRAHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: AL 3863) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: VA 2202005953) |
Enumeration Date | 2015-10-19 |
Last Update Date | 2015-12-14 |