| NPI | 1164969291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA ERICKSON Credentialer 832-212-7547 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 10619) |
| Enumeration Date | 2017-01-26 |
| Last Update Date | 2017-01-26 |