| NPI | 1104368323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIEL DION JOHNSON Speech Language Pathologist 551-225-0413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00760100) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2016-11-07 |