| NPI | 1487955621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI GOGOS Speech Language Pathologist 260-450-3617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IN 22002999A) |
| Enumeration Date | 2010-11-04 |
| Last Update Date | 2010-12-14 |