| NPI | 1023761558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACKENZEE HEATH Speech Language Pathologist 719-313-8690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2022-02-03 |