| NPI | 1104501170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA MARIE OLSEN Speech Language Pathologist 904-844-3136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-07-09 |