| NPI | 1366732455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON TUCKER Director 704-523-8027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 8075) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2011-04-11 |