| NPI | 1194370924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANA LACY MCQUITTY Speech Language Pathologist 336-580-1793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2019-08-08 |