| NPI | 1134859671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA R DEUTER Owner 870-974-9114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225200000X Physical Therapy Assistant | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2022-06-16 |