| NPI | 1043547284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA MCKENZIE Owner 904-463-2510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA9049) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2010-01-11 |