| NPI | 1114631041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY KAYE WITKOWSKI Speech Language Pathologist 325-668-8981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-01-05 |