| NPI | 1386027605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAECI SHA VICKERY Speech Language Pathologist 765-748-6558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251V00000X Voluntary or Charitable (Licence: CO SLP.0002081) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-06 |