| NPI | 1366129538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA SHACKLETON Owner 605-415-3611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |