| NPI | 1295404127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACI SOPER Slp/Owner 276-806-0662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2021-09-13 |