| NPI | 1194468744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAVANNAH A BRUECKER Speech Language Pathologist 920-471-2643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-04-20 |