| NPI | 1235817255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORTHEEN DOUGLAS WADE S Peech Language Pathologist 901-870-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-07-10 |