| NPI | 1437662814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAISEN STANGO Vice President 267-908-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: PA OC010741) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: PA BH002146) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2017-11-08 |