| NPI | 1154917466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIDYA H OFTEDAL Speech Language Pathologist 907-953-6812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-12-21 |
| Last Update Date | 2020-12-21 |