| NPI | 1023795192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HATHCOCK Speech Language Pathologist 505-720-0198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |