| NPI | 1124191978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN JOHNSON Business Manager 770-995-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-09-11 |