| NPI | 1154159820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMA CATARINA PROVENZANO Speech Language Pathologist 802-688-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-07-24 |