| NPI | 1487400867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA STOCKSTAD Owner 919-629-0202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2024-04-26 |
| Last Update Date | 2024-05-10 |