| NPI | 1982574687 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WA SLP.LL.70030853) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 38460) |
| 235Z00000X Speech-Language Pathologist, (Licence: MA SLP101710) | |
| Enumeration Date | 2025-11-07 |
| Last Update Date | 2025-11-07 |