| NPI | 1255055307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINA PULATOV Ccc Slp 347-393-9701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2022-10-03 |