| NPI | 1114654431 |
|---|---|
| Doing Business As | BLUE TIDE THERAPY |
| Entity Type | Organization |
| Authorized Contact | GARRETT OUTLAND Speech Language Pathologist 850-964-6162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2022-08-05 |