| NPI | 1417525916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY BLAKE Speech Language Pathologist 703-400-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-06-12 |
| Last Update Date | 2021-06-12 |