| NPI | 1063003507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANEY RENAE CARSON Speech Language Pathologist 318-884-8936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |