| NPI | 1114460086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY SEAN SHIRLEY Owner/CEO/Therapist 386-405-6586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: FL OT11104) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL 10889) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |