| NPI | 1124738109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN SEGURA Owner 480-913-0053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 224ZR0403X Occupational Therapy Assistant Driving and Community Mobility |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2024-02-07 |