| NPI | 1316339211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN NEVARES Speech Language Pathologist 619-952-9130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: CA SP15599) |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-03-02 |