| NPI | 1184112757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BROUSSALIAN Owner/Speech Langauge Pathologist 818-915-1966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2018-04-28 |
| Last Update Date | 2018-04-28 |