| NPI | 1003236993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANNE TERRY Owner 239-300-5966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: FL SA 12253) |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-12-23 |