| NPI | 1235883711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON AMANDA IDALSKI Owner, Speech Language Pathologist 810-305-0627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-12-07 |