| NPI | 1053972703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN T FAITH Owner 918-698-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2019-06-24 |
| Last Update Date | 2019-06-24 |