| NPI | 1467946624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY SULLIVAN Developmental Interventionist 270-766-7598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |