| NPI | 1275863250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE GRAY Speech Language Pathologist 505-417-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2010-01-13 |
| Last Update Date | 2010-01-13 |