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 |