| NPI | 1487065488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELLANY VIVANCO Speech Language Pathologist / Owner 305-602-8098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2016-07-11 |