| NPI | 1467713750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY ANN PARK Speech Language Pathologist 817-371-3353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 19126) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: TX 33891) |
| Enumeration Date | 2012-06-03 |
| Last Update Date | 2012-06-03 |