| NPI | 1225833916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ONTIVEROS Speech Language Pathologist 574-485-9062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |