| NPI | 1346533635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MICHELLE CLARK Speech Language Pathologist 708-868-0795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IN 22005039A) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |