| NPI | 1457941528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIKILRA SMITH Speech Language Pathologist 904-428-4653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-01-22 |
| Last Update Date | 2021-01-22 |