| NPI | 1114631686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY ROSE PANCRATZ Speech Language Pathologist 563-495-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-01-10 |