| NPI | 1083360226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA B BRADLEY Speech Language Pathologist 850-733-6403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2022-02-25 |