| NPI | 1093337073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY HENDRIX Credentialing Specialist 318-789-7239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2022-03-14 |