| NPI | 1992122675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: UT 8947377-4102) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: PA SL002966L) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2018-02-05 |