| NPI | 1194434043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE A WILFONG Owner 843-254-0722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2022-11-18 |
| Last Update Date | 2022-11-21 |