| NPI | 1073253688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA WAGNER CEO 866-219-8595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2024-01-05 |