| NPI | 1023573409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH WAGNER Speech Language Pathologist 907-390-0492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-02-09 |
| Last Update Date | 2019-02-12 |