| NPI | 1124978010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNA MATTOX Speech Language Pathologist 540-314-8892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2026-01-30 |
| Last Update Date | 2026-01-30 |