| NPI | 1104839786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE GAGE President 817-460-0378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 10121) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 102120) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2020-08-22 |