| NPI | 1225435589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDA DEON MOCK Speech Language Pathologist 435-705-3881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: UT 14083857) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2014-12-01 |