| NPI | 1164211132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE CARRASQUILLO STUMPF Speech Language Pathologist 708-200-9474 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-05-05 |
| Last Update Date | 2025-05-05 |