| NPI | 1356742852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CANDICE KO Owner 870-219-1086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AR SP#2890) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 224Z00000X Occupational Therapy Assistant | |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2014-09-16 |
| Last Update Date | 2022-07-25 |