| NPI | 1073236170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMIQUA JOHNSON Speech Language Pathologist 347-400-1772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |