| NPI | 1528591302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALILAH MIGNON MARQUES Director, Manager 904-652-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 2355S0801X Specialist/Technologist Speech-Language Assistant | |
| 235Z00000X Speech-Language Pathologist | |
| 261QH0700X Clinic/Center Hearing and Speech | |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2023-05-30 |