| NPI | 1043541931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHANEDRA EDWARDS ROBERTS Speech Language Pathologist 219-331-9514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IN 22003661A) |
| Enumeration Date | 2010-01-17 |
| Last Update Date | 2010-01-17 |