| NPI | 1144058025 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | TAISHA PELLETIER Speech Language Pathologist 347-641-4580  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, | 
| Enumeration Date | 2024-07-23 | 
| Last Update Date | 2024-07-23 |