| NPI | 1124356605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LONG DAVIS Owner 662-574-2634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MS S2545) |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2009-11-23 |