| NPI | 1104687532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLA HUIZENGA Speech Language Pathologist/Owner 260-316-5259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-22 |