| NPI | 1356880876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN L BOLAY Speech Pathologist 580-216-4321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OK 4013) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2017-02-16 |