| NPI | 1093253395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE L GRIDLEY Slp Owner 678-481-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP001692) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |