| NPI | 1982757340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP-0122) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) (Licence: AZ SLP-0122) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-07-08 |