Individual
Inactive
Sole proprietor
Provider details
NPI number
Contact information
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
948
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0948
NE DHHS
NE
Enumeration date
—
Last updated
—
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