| NPI | 1114624822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARIA CAMERON Speech Language Pathologist 952-412-5703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-08-10 |