| NPI | 1518565936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAISLEE S VAN ETTEN Slp/Owner 512-542-1265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2020-10-16 |