| NPI | 1477009090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN LEA BOLAY Speech Pathologist 580-216-4321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: OK 4013) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |