| NPI | 1235787342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHAIDRA C. BOYD Owner 678-920-0507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2019-09-01 |
| Last Update Date | 2019-09-01 |