| NPI | 1093026312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLBY MARA KEYSER Co Owner 267-775-3012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: PA SL005469L) |
| Additional Taxonomies | 225XP0200X Occupational Therapist Pediatrics (Licence: PA OC009270) |
| 225XP0200X Occupational Therapist Pediatrics (Licence: NJ 46TR00411800) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2010-07-01 |