| NPI | 1033635735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA OLIN Filer 917-217-7974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 012883-1) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2017-08-15 |