| NPI | 1134498363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI INGRAM Speech Language Pathologist/CEO 1866-849-4608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AL 2464) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: AL 588210) |
| 235Z00000X Speech-Language Pathologist, (Licence: AL 2455) | |
| 235Z00000X Speech-Language Pathologist, (Licence: AL 3145) | |
| 235Z00000X Speech-Language Pathologist, (Licence: AL 14034119) | |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |