NPI | 1417228131 |
---|---|
Entity Type | Organization |
Authorized Contact | TASHA R MARTIN-STANFORD Sole Proprietor 816-373-4841 |
Organization Subpart ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 116968) |
Enumeration Date | 2012-01-26 |
Last Update Date | 2012-01-26 |