| NPI | 1386291870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEA FITZGERALD Speech Language Pathologist/Owner 949-338-9891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-08-20 |
| Last Update Date | 2019-08-20 |