| NPI | 1124086822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI BENTSEN Manager 919-693-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251P0200X Physical Therapist Pediatrics | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2020-07-30 |