| NPI | 1447780028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROOKE LANE WILSON Owner, Speech Pathologist 321-230-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA11587) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2018-08-14 |