| NPI | 1104370220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY TEASE S,T 407-695-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA4443) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA2695) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-08-05 |