| NPI | 1376080812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATEKA KEGLER- TAYLOR Speech Language Pathologist 704-780-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: SC SC 5079) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: SC SC 5079) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |