| NPI | 1033848049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY F GRIMES Speech Language Pathologist 317-207-1613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |