| NPI | 1114204567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY LYNN FURMAN Clinic Director/Manager 920-840-0884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 2292) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2025-12-03 |