| NPI | 1104637198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYDNEY SHORT Owner 606-634-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2025-01-17 |
| Last Update Date | 2025-05-15 |