| NPI | 1275204968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANA S. BAULCH Owner 662-213-5815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2021-09-23 |