| NPI | 1093346058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIA DOUGLAS Speech Language Pathologist/Owner 251-610-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-01-29 |
| Last Update Date | 2024-08-12 |