| NPI | 1982941761 |
|---|---|
| Former Name | JESSICA MICHELLE MATOCHA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 106843) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO 0002374) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2016-03-29 |