| NPI | 1144989187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA HAMMEL Credentialing Manager 765-461-5410 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2021-12-23 |