| NPI | 1073292454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY JO LUKE Speech Language Pathologist 435-671-6728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |