| NPI | 1295540672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA BOHLEN Speech Language Pathologist 631-835-7401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-02-11 |