| NPI | 1396297776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN REEVES Owner 325-340-4020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM C-6121) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2020-04-27 |