| NPI | 1265932123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER C VICE Co Owner 606-465-9754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2018-03-29 |