| NPI | 1336609239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE ANNETTE BEAUMONT Speech Language Pathologist 320-200-4473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2021-11-15 |