| NPI | 1104567494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA WERNER Speech Language Pathologist 904-601-2079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2022-05-25 |