| NPI | 1104561471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE KAVANAGH Owner 480-518-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center Hearing and Speech |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 106S00000X Behavior Technician | |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| 2355S0801X Specialist/Technologist Speech-Language Assistant | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2022-05-02 |
| Last Update Date | 2022-10-12 |