| NPI | 1114750742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY LYNN CORREA Owner 262-207-4031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 104100000X Social Worker |
| 225100000X Physical Therapist | |
| 225A00000X Music Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-08-20 |