| NPI | 1396403408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA WYNTER RUSSELL Owner/Provider 917-579-6305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2021-12-06 |
| Last Update Date | 2022-04-12 |