| NPI | 1215435037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BETH OTTO Director 904-652-5408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |