| NPI | 1255904942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA MARIE WEST Speech Language Pathologist 870-588-7781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2021-07-20 |