| NPI | 1427371376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANEL FAGAN Director 732-948-6015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00610100) |
| Enumeration Date | 2010-03-07 |
| Last Update Date | 2010-03-07 |