| NPI | 1144043704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIERSTEN MARJORIBANKS Owner Speech Language Pathologist 631-416-6801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-11-18 |