| NPI | 1134562986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE TRODGLEN Owner 618-978-0254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |