| NPI | 1134858111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE SPENCER Speech Language Pathologist 757-453-4899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2024-08-05 |