NPI | 1124445705 |
---|---|
Entity Type | Organization |
Authorized Contact | LESLIE J MANTHEY Office Manager 803-661-5033 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 4676) |
Additional Taxonomies | 103K00000X Behavior Analyst |
225100000X Physical Therapist | |
225X00000X Occupational Therapist | |
Enumeration Date | 2014-03-21 |
Last Update Date | 2021-09-07 |