| NPI | 1003113408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH CLEMONS Lsls Cert. Avt, Ccc Slp 760-518-8563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CA Cert. AVT 1031201020) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP9784) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2011-02-21 |