| NPI | 1366771479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LEE GANGLUFF Speech Pathologist 574-339-5959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IN 01101056) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05006025A) |
| 225X00000X Occupational Therapist (Licence: IN 31000509A) | |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2010-03-19 |