| NPI | 1134931652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BASS OLDHAM Speech Language Pathologist 910-990-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-01-22 |