| NPI | 1114693579 |
|---|---|
| Doing Business As | SOUTHERN MAGNOLIA LLC |
| Entity Type | Organization |
| Authorized Contact | JAMIE GEERKEN Owner 239-265-5367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2022-02-23 |