| NPI | 1124698949 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY KIRSTEN VICKERS Owner 701-205-6318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2024-02-16 |