| NPI | 1083016893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A CHURCH Credentialing Specialist 906-337-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MI 7101004309) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |