| NPI | 1467772210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA L BUNTON Owner 765-414-5149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IN 22004114A) |
| Enumeration Date | 2010-06-03 |
| Last Update Date | 2010-06-03 |