| NPI | 1306431622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FATIMA QUEENNEL BULLOCK Speech Language Pathologist 317-869-8826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2021-03-08 |