| NPI | 1356067219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA B FEDDERN CEO 678-960-3063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2023-07-26 |