| NPI | 1083909030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALLENDA BROOKE TERRELL Owner/Speech Language Pathologist 678-618-9476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005683) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225100000X Physical Therapist | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2025-11-21 |