| NPI | 1124772843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GRUBBS Speech Language Pathologist 228-918-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |