| NPI | 1255508701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JANE GRANGER Speech Language Pathologist 502-797-4168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |