| NPI | 1215242391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY KUBLIN Sole Mbr 781-489-3697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 7659) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2012-09-07 |