| NPI | 1003570235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAITLYN MARIE SMITH Speech Language Pathologist 860-748-1346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-10-25 |