| NPI | 1043086523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY ANN BUSBOOM Speech Language Pathologist 770-625-0029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-11-27 |