| NPI | 1235697343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN TUBB Co Owner 251-510-5452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2019-03-07 |