| NPI | 1194349209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PONCIA Speech Language Pathologist, Owner 267-551-0889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |