| NPI | 1457079535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY SHOTTS Speech Language Pathologist 757-615-6284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2022-08-16 |
| Last Update Date | 2024-03-25 |