| NPI | 1336810779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND JUAREZ Owner 951-892-0529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 246Q00000X Spec/Tech, Pathology |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2023-04-25 |