| NPI | 1407349772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACRETIA BRUCE Owner 501-765-7951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 224ZE0001X Occupational Therapy Assistant, Environmental Modification |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |