| NPI | 1124044698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY L. BRUCE Owner 618-632-4222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2011-06-17 |