| NPI | 1073255659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANA GROEGER Speech Language Pathologist 386-697-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2022-04-12 |