| NPI | 1154946366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA FOURTH Speech Language Pathologist/Owner 407-435-0191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2020-06-12 |