| NPI | 1477212496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN SULLIVAN Speech Language Pathologist 331-704-0386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2021-12-17 |
| Last Update Date | 2021-12-17 |