| NPI | 1063095602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY CANNON Speech Language Pathologist 830-315-6400 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-05-02 |
| Last Update Date | 2021-05-02 |