| NPI | 1225260839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCY J WILSON Speech Language Pathologist 757-749-1638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2009-08-14 |
| Last Update Date | 2016-01-28 |