NPI | 1053027441 |
---|---|
Doing Business As | SUPERNOVA SPEECH THERAPY |
Entity Type | Organization |
Authorized Contact | KATHY MAGANA-GOMEZ CEO/Speech Language Pathologist 562-317-1477 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2023-01-27 |
Last Update Date | 2023-01-27 |