| NPI | 1124602727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE ECKART Credentialing Specialist 405-247-0285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2022-01-05 |