| NPI | 1366596579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L THORNTON Co Owner Speech Language Patholog 631-581-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NY 11984-1) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |