| NPI | 1154592335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISHUNDA TULLIS Owner 772-464-3303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA5222) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2021-07-16 |