| NPI | 1982155958 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202008380) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OR 13152) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |