| NPI | 1134011281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACIE CLARK Speech Language Pathologist 949-599-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-07-15 |
| Last Update Date | 2025-07-18 |