| NPI | 1104220631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN E KIESTER Owner/Speech Pathologist 704-953-9653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006006) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2014-10-13 |