| NPI | 1003273343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDI MICHAEL Owner 989-598-0400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101001389) |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2016-01-18 |