| NPI | 1104606631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSIDY ANN STRADLING Speech Language Pathologist 505-306-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-10-05 |