| NPI | 1003589789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH COSTELLO Speech Language Pathologist 775-852-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2024-07-27 |