| NPI | 1053855452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BETH OTTO Owner/Director 904-652-5408 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 11834) |
| Enumeration Date | 2016-12-05 |
| Last Update Date | 2019-03-22 |