| NPI | 1508438219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP MENARD Member 734-657-1470 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 225100000X Physical Therapist | |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2021-07-13 |
| Last Update Date | 2021-07-13 |