| NPI | 1366829137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA LANE GRAY Speech Language Pathologist 706-833-7376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: GA SLP004870) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-04-30 |