| NPI | 1407602121 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | KIMBERLY T BURBANK Owner 917-670-1825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-08-15 |