| NPI | 1093154148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L. FANIEL Speech Language Pathologist 877-852-0246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |