| NPI | 1477813129 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | EMILY ELLEN DYKSTRA Speech Language Pathologist 407-928-5378  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist,   (Licence: FL SA7153)  | 
| Enumeration Date | 2012-05-29 | 
| Last Update Date | 2012-05-29 |