| NPI | 1447686159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE SHIWBALAK Speech Language Pathologist 85577-325-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 7327663) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |