| NPI | 1013986934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN MEKEEL Director 239-455-9525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2020-08-22 |